John F Bebawy

John F Bebawy
Northwestern University | NU · Department of Anesthesiology

MD

About

50
Publications
9,556
Reads
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643
Citations
Additional affiliations
August 2008 - January 2021
Northwestern University
Position
  • Professor (Associate)

Publications

Publications (50)
Article
2016 Background: The blood-brain barrier (BBB) is a major impediment to pharmacological treatment of gliomas, a diffuse tumor infiltrating the peri-tumoral normal brain. Low-intensity pulsed ultrasound directed at the brain with concomitant administration of intravenous microbubbles (LIPU/MB), temporarily opens the BBB. This technique was previousl...
Article
Burst-suppression is an electroencephalographic pattern that results from a diverse array of pathophysiological causes and/or metabolic neuronal suppression secondary to the administration of anesthetic medications. The purpose of this review is to provide an overview of the physiological mechanisms that underlie the burst-suppression pattern and t...
Article
Full-text available
Administration of rocuronium to facilitate intubation has traditionally been regarded as acceptable for intraoperative motor evoked potential (MEP) monitoring because of sufficiently rapid spontaneous neuromuscular blockade recovery. We hypothesized that residual neuromuscular blockade, in an amount that could hinder optimal neuromonitoring in pati...
Article
Defining optimal hemodynamic targets for brain-injured patients is a challenging undertaking. The physiological interference observed in various intracranial pathologies can have varying effects on cerebral physiology at different time points. This narrative review provides an overview of cerebral autoregulatory physiology and common misconceptions...
Chapter
Neurological complications of cardiac surgery have a large impact on patient morbidity and mortality. Clinicians have relied on several modes of monitoring of the central nervous system as a means for reducing the risk of these complications including the electroencephalogram. While electroencephalogram changes are specific for cerebral ischemia, t...
Article
Full-text available
Background: The COVID-19 pandemic is an international crisis placing tremendous strain on medical systems around the world. Like other specialties, neuroanesthesiology has been adversely affected and training programs have had to quickly adapt to the constantly changing environment. Methods: An email-based survey was used to evaluate the effects...
Article
Full-text available
Background: Patients with intracranial tumors are more sensitive to anesthetics than the general population and are therefore more susceptible to postoperative neurologic and neurocognitive dysfunction. Sevoflurane or propofol combined with remifentanil are widely used general anesthetic regimens for craniotomy, with neither regimen shown to be su...
Article
Human albumin has been used extensively for decades as a nonwhole blood plasma replacement fluid in the perioperative and critical care setting. Its potential advantages as a highly effective volume expander must be weighed, however, against its potential harm for patients in the context of various neurological states and for various neurosurgical...
Preprint
Background Patients with intracranial tumors are more sensitive to sedatives and general anesthetics than the general population and are therefore more susceptible to postoperative neurologic and neurocognitive dysfunction. Sevoflurane or propofol combined with remifentanil are widely used general anesthetic regimens for craniotomy, with neither re...
Article
Intraoperative neurophysiologic monitoring (IONM) includes various neurophysiologic tests which assess the functional integrity of the central and peripheral nervous systems during surgical procedures which place these structures at risk for iatrogenic injury. The rational for using IONM is to provide timely feedback of changes in neural function t...
Article
Full-text available
Cognitive aids and evidence-based checklists are frequently utilized in complex situations across many disciplines and sectors. The purpose of such aids is not simply to provide instruction so as to fulfill a task, but rather to ensure that all contingencies related to the emergency are considered and accounted for and that the task at hand is comp...
Article
The α2-adrenergic receptor agonist dexmedetomidine has sedative, anxiolytic, analgesic, and sympatholytic effects. The potential advantages of neuroprotection, minimal impact on neuronal function, stable hemodynamics, opioid and anesthesia sparing effects, and minimal respiratory depression during awake procedures render it an effective anesthetic...
Article
Neurological complications of cardiac surgery have a large impact on patient outcomes. In this review we critique the value of several modes of central nervous system monitoring for improving perioperative care. The electroencephalogram (EEG) has been used as a means for detecting brain ischemia. While EEG changes are specific for ischemia, the rel...
Article
Background: Multilevel spine fusion surgery for adult deformity correction is associated with significant blood loss and coagulopathy. Tranexamic acid reduces blood loss in high risk surgery, but the efficacy of a low dose regimen is unknown. Methods: Sixty-one patients undergoing multilevel complex spinal fusion with and without osteotomies wer...
Chapter
An anterior cervical discectomy and fusion (ACDF) is a routinely performed surgery whose purpose is to relieve spinal stenosis, remove intervertebral disk and bony matter which may be impinging upon neural elements, and also to mechanically stabilize the cervical spine after such material is removed. The safety of an ACDF for patients with cervical...
Article
Study objective: The purpose of this study was to identify risk factors associated with intraoperative blood transfusions in patients presenting for intracranial aneurysm surgery in the current era of more restrictive transfusion guidelines. Design: Retrospective observational cohort study with stepwise, multivariate binary logistic regression a...
Article
Full-text available
Background: Residual neuromuscular blockade after general anesthesia using nondepolarizing neuromuscular blocking agents has pathophysiological, clinical, and economic consequences. A significant number of patients under muscle relaxation sustain residual curarization. Methods: Observational, prospective, multicenter study of a cohort of patient...
Article
Full-text available
Lumbar puncture for spinal or epidural anesthesia is commonly performed by palpating bony landmarks, but identification of the desired intervertebral level is often inaccurate. It is unclear whether such inaccuracy is related to patient factors, such as body mass index and degree of lumbar flexion. We hypothesized that overweight patients and patie...
Article
Background: Emergence hypertension after craniotomy is a well-documented phenomenon for which natural history is poorly understood. Most clinicians attribute this phenomenon to an acute and transient increase in catecholamine release, but other mechanisms such as neurogenic hypertension or activation of the renin-angiotensin-aldosterone system hav...
Article
Background: Many factors affect the accuracy of hemoglobin concentration values. In this study, we evaluated whether the hemoglobin concentration obtained by means of arterial blood gas (ABG) co-oximetry and complete blood count (CBC) central laboratory techniques clinically correlate when using simultaneous measurements of hemoglobin concentratio...
Article
Objective: The aims of this study were to determine the efficacy and feasibility of implementation of the intraoperative component of a high risk spine (HRS) protocol for improving perioperative patient safety in complex spine fusion surgery. Methods: In this paired availability study, the total number of red blood cell units transfused was used...
Article
Study design: Observational cohort study. Objective: To determine the accuracy of the Revised Cardiac Risk Index (RCRI) in predicting major adverse cardiac events in patients undergoing spine fusion surgery of 3 levels or more. Summary of background data: Preoperative cardiac testing is extensively guided by the RCRI, which was developed and v...
Article
Surgery for posterior spine instrumentation often requires major transfusion. The aim of this study was to develop and test the validity of a model for predicting intraoperative major transfusion (>4 U total red blood cells), based on preoperative patient and surgical variables, that was applicable to adult patients undergoing cervical, thoracic, a...
Article
When temporary arterial occlusion of the parent artery is difficult for anatomical reasons, or when inadvertent aneurysmal rupture occurs during surgical dissection, adenosine administration can be used to produce flow arrest and brief, profound systemic hypotension that can facilitate intracranial aneurysm clip ligation. There is a concern, howeve...
Article
Web-based delivery of educational material by scientific societies appears to have increased recently. However, the utilization of such efforts by the members of professional societies is unknown. We report the experience with delivery of educational resources on the Web site of the Society for Neuroscience in Anesthesiology and Critical Care (SNAC...
Article
: Mannitol is often used during intracranial surgery to improve surgical exposure. Furosemide is often added to mannitol to augment this effect. The concern exists, however, that the augmented diuresis caused by the addition of furosemide to mannitol may cause hypovolemia and hypoperfusion, hypokalemia, and hyponatremia. We examined the intraoperat...
Chapter
An anterior cervical discectomy and fusion (ACDF) is a routinely performed surgery whose purpose is to relieve spinal stenosis, remove intervertebral disc and bony matter which may be impinging upon neural elements, and also to mechanically stabilize the cervical spine after such material is removed. Herniated intervertebral disc material or osteop...
Article
Objective: To review the experience at a single institution with motor evoked potential (MEP) monitoring during intracranial aneurysm surgery to determine the incidence of unacceptable movement. Methods: Neurophysiology event logs and anesthetic records from 220 craniotomies for aneurysm clipping were reviewed for unacceptable patient movement o...
Article
There has been a renewed interest in the recent literature regarding the proposed benefits of systemic steroids in the perioperative period. Among these benefits are the relief of postoperative pain, the decrease in postoperative nausea, and a higher overall multiparameter quality of recovery. Perioperative steroids, however, are not without their...
Article
Loeys-Dietz syndrome (LDS) is a newly described connective tissue disease associated with aortic aneurysms. A strong association between LDS and intracranial aneurysms has not yet been documented in the literature. We present the first detailed report of an intracranial aneurysm finding in an LDS patient. The patient is a 20-year-old female recentl...
Article
Clip application for temporary occlusion is not always practical or feasible. Adenosine is an alternative that provides brief periods of flow arrest that can be used to advantage in aneurysm surgery, but little has been published on its utility for this indication. To report our 2-year consecutive experience with 40 aneurysms in 40 patients for who...
Article
Compartment syndrome caused by an infiltrated intravenous catheter has been previously reported, but there are no reports of compartment syndrome caused by fluids and/or medications dispensed by a properly functioning drug infusion pump. A case in which a commonly used drug infusion pump delivered propofol and remifentanil under high pressure, lead...
Article
The varying point at which the spinal cord terminates in the lumbar spinal canal may affect the incidence of spinal cord injuries associated with needle insertion for spinal anaesthesia, especially in patients with vertebral body or intervertebral disc disease. This is a complication which has been frequently reported when spinal needle insertion w...
Article
Adenosine-induced transient flow arrest has been used to facilitate clip ligation of intracranial aneurysms. However, the starting dose that is most likely to produce an adequate duration of profound hypotension remains unclear. We reviewed our experience to determine the dose-response relationship and apparent perioperative safety profile of adeno...
Article
The purpose of this study was to examine the utility and feasibility of using alternative anterior reference leads when measuring left posterior tibial nerve somatosensory evoked potentials (SEPs). With IRB approval, 12 patients were monitored using both traditional (FPz and C4') and alternative anterior (F3 and F4) reference leads during routine s...

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